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1.
IEEE J Biomed Health Inform ; 26(6): 2481-2492, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1878964

ABSTRACT

OBJECTIVE: At-home monitoring of respiration is of critical urgency especially in the era of the global pandemic due to COVID-19. Electrocardiogram (ECG) and seismocardiogram (SCG) signals-measured in less cumbersome contact form factors than the conventional sealed mask that measures respiratory air flow-are promising solutions for respiratory monitoring. In particular, respiratory rates (RR) can be estimated from ECG-derived respiratory (EDR) and SCG-derived respiratory (SDR) signals. Yet, non-respiratory artifacts might still be present in these surrogates of respiratory signals, hindering the accuracy of the RRs estimated. METHODS: In this paper, we propose a novel U-Net-based cascaded framework to address this problem. The EDR and SDR signals were transformed to the spectro-temporal domain and subsequently denoised by a 2D U-Net to reduce the non-respiratory artifacts. MAJOR RESULTS: We have shown that the U-Net that fused an EDR input and an SDR input achieved a low mean absolute error of 0.82 breaths per minute (bpm) and a coefficient of determination (R2) of 0.89 using data collected from our chest-worn wearable patch. We also qualitatively provided insights on the complementariness between EDR and SDR signals and demonstrated the generalizability of the proposed framework. CONCLUSION: ECG and SCG collected from a chest-worn wearable patch can complement each other and yield reliable RR estimation using the proposed cascaded framework. SIGNIFICANCE: We anticipate that convenient and comfortable ECG and SCG measurement systems can be augmented with this framework to facilitate pervasive and accurate RR measurement.


Subject(s)
COVID-19 , Respiratory Rate , Artifacts , Electrocardiography , Humans , Respiration , Signal Processing, Computer-Assisted
2.
BMC Pulm Med ; 22(1): 121, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1822183

ABSTRACT

BACKGROUND: The respiratory rate-oxygenation (ROX) index has been increasingly applied to predict the outcome of high-flow nasal cannula (HFNC) in pneumonia patients with acute hypoxemic respiratory failure (AHRF). However, its diagnostic accuracy for the HFNC outcome has not yet been systematically assessed. This meta-analysis sought to evaluate the predictive performance of the ROC index for the successful weaning from HFNC in pneumonia patients with AHRF. METHODS: A literature search was conducted on electronic databases through February 12, 2022, to retrieve studies that investigated the diagnostic accuracy of the ROC index for the outcome of HFNC application in pneumonia patients with AHRF. The area under the hierarchical summary receiver operating characteristic curve (AUHSROC) was estimated as the primary measure of diagnostic accuracy due to the varied cutoff values of the index. We observed the distribution of the cutoff values and estimated the optimal threshold with corresponding 95% confidential interval (CI). RESULTS: Thirteen observational studies comprising 1751 patients were included, of whom 1003 (57.3%) successfully weaned from HFNC. The ROC index exhibits good performance for predicting the successful weaning from HFNC in pneumonia patients with AHRF, with an AUHSROC of 0.81 (95% CI 0.77-0.84), a pooled sensitivity of 0.71 (95% CI 0.64-0.78), and a pooled specificity of 0.78 (95% CI 0.70-0.84). The cutoff values of the ROX index were nearly conically symmetrically distributed; most data were centered between 4.5 and 6.0, and the mean and median values were 4.8 (95% CI 4.2-5.4) and 5.3 (95% CI 4.2-5.5), respectively. Moreover, the AUHSROC in the subgroup of measurement within 6 h after commencing HFNC was comparable to that in the subgroup of measurement during 6-12 h. The stratified analyses also suggested that the ROC index was a reliable predictor of HFNC success in pneumonia patients with coronavirus disease 2019. CONCLUSIONS: In pneumonia patients with AHRF, the ROX index measured within 12 h after HFNC initiation is a good predictor of successful weaning from HFNC. The range of 4.2-5.4 may represent the optimal confidence interval for the prediction of HFNC outcome.


Subject(s)
COVID-19 , Pneumonia , Respiratory Insufficiency , Cannula , Humans , Pneumonia/complications , Pneumonia/diagnosis , Pneumonia/therapy , Respiratory Insufficiency/therapy , Respiratory Rate
3.
Sensors (Basel) ; 22(7)2022 Mar 25.
Article in English | MEDLINE | ID: covidwho-1785895

ABSTRACT

Heart rate (HR) and respiratory rate (fR) can be estimated by processing videos framing the upper body and face regions without any physical contact with the subject. This paper proposed a technique for continuously monitoring HR and fR via a multi-ROI approach based on the spectral analysis of RGB video frames recorded with a mobile device (i.e., a smartphone's camera). The respiratory signal was estimated by the motion of the chest, whereas the cardiac signal was retrieved from the pulsatile activity at the level of right and left cheeks and forehead. Videos were recorded from 18 healthy volunteers in four sessions with different user-camera distances (i.e., 0.5 m and 1.0 m) and illumination conditions (i.e., natural and artificial light). For HR estimation, three approaches were investigated based on single or multi-ROI approaches. A commercially available multiparametric device was used to record reference respiratory signals and electrocardiogram (ECG). The results demonstrated that the multi-ROI approach outperforms the single-ROI approach providing temporal trends of both the vital parameters comparable to those provided by the reference, with a mean absolute error (MAE) consistently below 1 breaths·min-1 for fR in all the scenarios, and a MAE between 0.7 bpm and 6 bpm for HR estimation, whose values increase at higher distances.


Subject(s)
Electrocardiography , Respiratory Rate , Computers, Handheld , Heart Rate , Humans , Monitoring, Physiologic , Respiratory Rate/physiology , Signal Processing, Computer-Assisted
4.
Can J Anaesth ; 67(10): 1393-1404, 2020 10.
Article in English | MEDLINE | ID: covidwho-1777843

ABSTRACT

Pulmonary complications are the most common clinical manifestations of coronavirus disease (COVID-19). From recent clinical observation, two phenotypes have emerged: a low elastance or L-type and a high elastance or H-type. Clinical presentation, pathophysiology, pulmonary mechanics, radiological and ultrasound findings of these two phenotypes are different. Consequently, the therapeutic approach also varies between the two. We propose a management algorithm that combines the respiratory rate and oxygenation index with bedside lung ultrasound examination and monitoring that could help determine earlier the requirement for intubation and other surveillance of COVID-19 patients with respiratory failure.


RéSUMé: Les complications pulmonaires du coronavirus (COVID-19) constituent ses manifestations cliniques les plus fréquentes. De récentes observations cliniques ont fait émerger deux phénotypes : le phénotype à élastance faible ou type L (low), et le phénotype à élastance élevée, ou type H (high). La présentation clinique, la physiopathologie, les mécanismes pulmonaires, ainsi que les observations radiologiques et échographiques de ces deux différents phénotypes sont différents. L'approche thérapeutique variera par conséquent selon le phénotype des patients atteints de COVID-19 souffrant d'insuffisance respiratoire.


Subject(s)
Coronavirus Infections/complications , Lung/diagnostic imaging , Pneumonia, Viral/complications , Respiratory Insufficiency/diagnostic imaging , Ultrasonography , Acute Disease , Algorithms , COVID-19 , Coronavirus Infections/diagnostic imaging , Humans , Lung/physiopathology , Lung/virology , Oxygen/metabolism , Pandemics , Phenotype , Pneumonia, Viral/diagnostic imaging , Point-of-Care Systems , Respiratory Insufficiency/virology , Respiratory Rate/physiology
5.
Balkan Med J ; 39(2): 140-147, 2022 03 14.
Article in English | MEDLINE | ID: covidwho-1753823

ABSTRACT

Background: The prediction of high-flow nasal oxygen (HFNO) failure in patients with coronavirus disease-2019 (COVID-19) having acute respiratory failure (ARF) may prevent delayed intubation and decrease mortality. Aims: To define the related risk factors to HFNO failure and hospital mortality. Study Design: Retrospective cohort study. Methods: To this study, 85 critically ill patients (≥18 years) with COVID-19 related acute kidney injury who were treated with HFNO were enrolled. Treatment success was defined as the de-escalation of the oxygenation support to the conventional oxygen therapies. HFNO therapy failure was determined as the need for invasive mechanical ventilation or death. The patients were divided into HFNO-failure (HFNO-F) and HFNO-success (HFNO-S) groups. Electronic medical records and laboratory data were screened for all patients. Respiratory rate oxygenation (ROX) index on the first hour and chest computed tomography (CT) severity score were calculated. Factors related to HFNO therapy failure and mortality were defined. Results: This study assessed 85 patients (median age 67 years, 69.4% male) who were divided into two groups as HFNO success (n = 33) and HFNO failure (n = 52). The respiratory rate oxygenation (ROX) was measured at 1 hour and the computed tomography (CT) score indicated HFNO failure and intubation, with an area under the receiver operating characteristic of 0.695 for the ROX index and 0.628 for the CT score. A ROX index of <3.81 and a CT score of >15 in the first hour of therapy were the predictors of HFNO failure and intubation. Age, Acute Physiology and Chronic Health Evaluation II score, arterial blood gas findings "(i.e., partial pressure of oxygen [PaO2], PaO2 [fraction of inspired oxygen]/SO2 [oxygen saturation] ratio)", and D-dimer levels were also associated with HFNO failure; however, based on logistic regression analysis, a calculated ROX on the first hour of therapy of <3.81 (odds ratio [OR] = 4.78, 95% confidence interval [CI] = 1.75-13.02, P = 0.001) and a chest CT score of >15 (OR = 2.83, 95% CI = 1.01-7.88, P = <0.001) were the only independent risk factors. In logistic regression analysis, a ROX calculated on the first hour of therapy of <3.81 (OR = 4.78, [95% CI = 1.75-13.02], P = 0.001) and a chest CT score of >15 (OR 2.83, 95% CI = 1.01-7.88, P = <0.001) were the independent risk factors for the HFNO failure. The intensive care unit and hospital mortality rates were 80.2% and 82.7%, respectively, in the HFNO failure group. Conclusion: The early prediction of HFNO therapy failure is essential considering the high mortality rate in patients with HFNO therapy failure. Using the ROX index and the chest CT severity score combined with the other clinical parameters may reduce mortality. Additionally, multi-centre observational studies are needed to define the predictive value of ROX and chest CT score not only for COVID-19 but also other causes of ARF.


Subject(s)
COVID-19 , Coronavirus , Aged , Critical Illness/therapy , Female , Humans , Male , Oxygen/therapeutic use , Respiratory Rate , Retrospective Studies , Tomography, X-Ray Computed
6.
J Crit Care ; 69: 154020, 2022 06.
Article in English | MEDLINE | ID: covidwho-1747826

ABSTRACT

PURPOSE: Increased respiratory drive and respiratory effort are major features of acute hypoxemic respiratory failure (AHRF) and might help to predict the need for intubation. We aimed to explore the feasibility of a non-invasive respiratory drive evaluation and describe how these parameters may help to predict the need for intubation. MATERIALS AND METHODS: We conducted a prospective observational study. All consecutive patients with COVID-19-related AHRF requiring high-flow nasal cannula (HFNC) were screened for inclusion. Physiologic data (including: occlusion pressure (P0.1), tidal volume (Vt), inspiratory time (Ti), peak and mean inspiratory flow (Vt/Ti)) were collected during a short continuous positive airway pressure (CPAP) session. Measurements were repeated once, 12-24 h later. RESULTS: Measurements were completed in 31 patients after the screening of 45 patients (70%). P0.1 was high (4.4 [2.7-5.1]), but it was not significantly higher in patients who were intubated. The Vt (p = .006), Vt/Ti (p = .019), minute ventilation (p = .006), and Ti/Ttot (p = .003) were higher among intubated patients compared to non-intubated patients. Intubated patients had a significant increase in their diaphragm thickening fraction, Vt, and Vt/Ti over time. CONCLUSIONS: Non-invasive assessment of respiratory drive was feasible in patients with AHRF and showed an increased P0.1, although it was not predictive of intubation.


Subject(s)
COVID-19 , Noninvasive Ventilation , Respiratory Insufficiency , COVID-19/therapy , Continuous Positive Airway Pressure , Feasibility Studies , Humans , Respiratory Insufficiency/therapy , Respiratory Rate
7.
J Appl Physiol (1985) ; 132(2): 448-458, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1691222

ABSTRACT

Although vaccines against SARS-CoV-2 have been proven safe and effective, transient side-effects lasting 24-48 h postvaccination have been reported. To better understand the subjective and objective response to COVID-19 vaccination, we conducted a retrospective analysis on 69,619 subscribers to a wrist-worn biometric device (WHOOP Inc., Boston, MA) who received either the AstraZeneca, Janssen/Johnson & Johnson, Moderna, or Pfizer/BioNTech vaccine. The WHOOP device measures resting heart rate (RHR), heart rate variability (HRV), respiratory rate (RR), and sleep architecture, and these physiological measures were normalized to the same day of the week, 1 wk before vaccination. Averaging across vaccines, RHR, RR, and percent sleep derived from light sleep were elevated on the first night following vaccination and returned to baseline within 4 nights postvaccination. When statistical differences were observed between doses on the first night postvaccination, larger deviations in physiological measures were observed following the first dose of AstraZeneca and the second dose of Moderna and Pfizer/BioNTech. When statistical differences were observed between age groups or gender on the first night postvaccination, larger deviations in physiological measures were observed in younger populations and in females (compared with males). When combining self-reported symptoms (fatigue, muscle aches, headache, chills, or fever) with the objectively measured physiological parameters, we found that self-reporting fever or chills had the strongest association with deviations in physiological measures following vaccination. In summary, these results suggest that COVID-19 vaccines temporarily affect cardiovascular, respiratory, and sleep physiology and that dose, gender, and age affect the physiological response to vaccination.NEW & NOTEWORTHY Here we report the first large-scale study investigating the effect of COVID-19 vaccines on cardiovascular, respiratory, and sleep physiology. We find that vaccines temporarily impact measures of cardiovascular, respiratory, and sleep physiology and that the degree of change in physiology is influenced by the manufacturer and dose of the vaccine and the gender and age of the vaccine recipient. These results provide insights into physiological changes that occur with COVID-19 vaccination and indicate that the unique responses that occur postvaccination may depend on manufacturer, dose, gender, and age.


Subject(s)
COVID-19 , Wearable Electronic Devices , Biometry , COVID-19 Vaccines , Female , Humans , Male , Respiratory Rate , Retrospective Studies , SARS-CoV-2 , Sleep
8.
EBioMedicine ; 76: 103868, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1676709

ABSTRACT

BACKGROUND: The manufacturing of any standard mechanical ventilator cannot rapidly be upscaled to several thousand units per week, largely due to supply chain limitations. The aim of this study was to design, verify and perform a pre-clinical evaluation of a mechanical ventilator based on components not required for standard ventilators, and that met the specifications provided by the Medicines and Healthcare Products Regulatory Agency (MHRA) for rapidly-manufactured ventilator systems (RMVS). METHODS: The design utilises closed-loop negative feedback control, with real-time monitoring and alarms. Using a standard test lung, we determined the difference between delivered and target tidal volume (VT) at respiratory rates between 20 and 29 breaths per minute, and the ventilator's ability to deliver consistent VT during continuous operation for >14 days (RMVS specification). Additionally, four anaesthetised domestic pigs (3 male-1 female) were studied before and after lung injury to provide evidence of the ventilator's functionality, and ability to support spontaneous breathing. FINDINGS: Continuous operation lasted 23 days, when the greatest difference between delivered and target VT was 10% at inspiratory flow rates >825 mL/s. In the pre-clinical evaluation, the VT difference was -1 (-90 to 88) mL [mean (LoA)], and positive end-expiratory pressure (PEEP) difference was -2 (-8 to 4) cmH2O. VT delivery being triggered by pressures below PEEP demonstrated spontaneous ventilation support. INTERPRETATION: The mechanical ventilator presented meets the MHRA therapy standards for RMVS and, being based on largely available components, can be manufactured at scale. FUNDING: Work supported by Wellcome/EPSRC Centre for Medical Engineering,King's Together Fund and Oxford University.


Subject(s)
Equipment Design , Respiration, Artificial/instrumentation , Animals , COVID-19/pathology , COVID-19/prevention & control , COVID-19/virology , Female , Male , Respiratory Rate , SARS-CoV-2/isolation & purification , Swine , Tidal Volume
10.
Crit Care Med ; 50(7): e638-e642, 2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-1672318

ABSTRACT

OBJECTIVES: The respiratory rate-oxygenation (ROX) index is a fraction of oxygen saturation, Fio2, and respiratory rate that has been validated to predict receipt of invasive mechanical ventilation in patients receiving high-flow nasal cannula (HFNC). This study aimed to validate ROX in a cohort of inpatients with COVID-19-related respiratory failure. DESIGN: Retrospective validation of the ROX index. We calculated sensitivity, specificity, positive predictive value, negative predictive value, and 95% CIs of ROX for invasive mechanical ventilation any time during hospitalization. SETTING: Twenty-one hospitals of Kaiser Permanente Northern California, an integrated healthcare delivery system. PATIENTS: We identified adults with positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test within 3 weeks of, or during, hospitalization between February 1, 2020, and December 31, 2020. We calculated ROX at 12 hours after HFNC initiation. We grouped patients as low (≥ 4.88), intermediate (< 4.88 and ≥ 3.85), or high (< 3.85) risk using previously published thresholds. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We identified 1,847 patients who had no limitation of life support. Of these, 525 (31.7%) received invasive mechanical ventilation any time during hospitalization and 511 died (27.7%). The sensitivity, specificity, positive predictive value, and negative predictive value of 12-hour ROX threshold (< 3.85) predicting invasive mechanical ventilation were 32.3% (95% CI, 28.5-36.3%), 89.8% (95% CI, 88.0-91.4%), 59.4% (95% CI, 53.8-64.9%), and 74.1% (95% CI, 71.8-76.3%), respectively. CONCLUSIONS: The 12-hour ROX index has a positive predictive value (59.4%) using threshold of less than 3.85 for COVID-19 patients needing invasive mechanical ventilation. Our health system has embedded ROX into the electronic health record to prioritize rounding during periods of inpatient surge.


Subject(s)
COVID-19 , Noninvasive Ventilation , Respiratory Insufficiency , Adult , Blood Gas Analysis , COVID-19/therapy , Cannula , Humans , Oxygen Inhalation Therapy , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy , Respiratory Rate , Retrospective Studies
11.
Respir Physiol Neurobiol ; 298: 103842, 2022 04.
Article in English | MEDLINE | ID: covidwho-1655093

ABSTRACT

BACKGROUND: Noninvasive ventilation (NIV) and High-flow nasal cannula (HFNC) are the main forms of treatment for acute respiratory failure. This study aimed to evaluate the effect, safety, and applicability of the NIV and HFNC in patients with acute hypoxemic respiratory failure (AHRF) caused by COVID-19. METHODS: In this retrospective study, we monitored the effect of NIV and HFNC on the SpO2 and respiratory rate before, during, and after treatment, length of stay, rates of endotracheal intubation, and mortality in patients with AHRF caused by COVID-19. Additionally, data regarding RT-PCR from physiotherapists who were directly involved in assisting COVID-19 patients and non-COVID-19. RESULTS: 62.2 % of patients were treated with HFNC. ROX index increased during and after NIV and HFNC treatment (P < 0.05). SpO2 increased during NIV treatment (P < 0.05), but was not maintained after treatment (P = 0.17). In addition, there was no difference in the respiratory rate during or after the NIV (P = 0.95) or HFNC (P = 0.60) treatment. The mortality rate was 35.7 % for NIV vs 21.4 % for HFNC (P = 0.45), while the total endotracheal intubation rate was 57.1 % for NIV vs 69.6 % for HFNC (P = 0.49). Two adverse events occurred during treatment with NIV and eight occurred during treatment with HFNC. There was no difference in the physiotherapists who tested positive for SARS-COV-2 directly involved in assisting COVID-19 patients and non-COVID-19 ones (P = 0.81). CONCLUSION: The application of NIV and HFNC in the critical care unit is feasible and associated with favorable outcomes. In addition, there was no increase in the infection of physiotherapists with SARS-CoV-2.


Subject(s)
COVID-19/therapy , Cannula , Intubation, Intratracheal , Noninvasive Ventilation , Outcome and Process Assessment, Health Care , Oxygen/administration & dosage , Positive-Pressure Respiration , Respiratory Insufficiency/therapy , Respiratory Rate/drug effects , Acute Disease , Administration, Inhalation , Adult , Aged , Aged, 80 and over , Brazil , COVID-19/complications , COVID-19/mortality , Cannula/adverse effects , Cannula/standards , Cannula/statistics & numerical data , Feasibility Studies , Female , Humans , Intensive Care Units , Intubation, Intratracheal/statistics & numerical data , Length of Stay/statistics & numerical data , Male , Middle Aged , Noninvasive Ventilation/adverse effects , Noninvasive Ventilation/methods , Noninvasive Ventilation/standards , Noninvasive Ventilation/statistics & numerical data , Outcome and Process Assessment, Health Care/statistics & numerical data , Physical Therapists , Positive-Pressure Respiration/adverse effects , Positive-Pressure Respiration/standards , Positive-Pressure Respiration/statistics & numerical data , Respiratory Insufficiency/etiology , Respiratory Insufficiency/mortality , Retrospective Studies
12.
Sensors (Basel) ; 22(2)2022 Jan 14.
Article in English | MEDLINE | ID: covidwho-1625927

ABSTRACT

In this study, a contactless vital signs monitoring system was proposed, which can measure body temperature (BT), heart rate (HR) and respiration rate (RR) for people with and without face masks using a thermal and an RGB camera. The convolution neural network (CNN) based face detector was applied and three regions of interest (ROIs) were located based on facial landmarks for vital sign estimation. Ten healthy subjects from a variety of ethnic backgrounds with skin colors from pale white to darker brown participated in several different experiments. The absolute error (AE) between the estimated HR using the proposed method and the reference HR from all experiments is 2.70±2.28 beats/min (mean ± std), and the AE between the estimated RR and the reference RR from all experiments is 1.47±1.33 breaths/min (mean ± std) at a distance of 0.6-1.2 m.


Subject(s)
COVID-19 , Algorithms , Body Temperature , Heart Rate , Humans , Monitoring, Physiologic , Respiratory Rate , SARS-CoV-2 , Vital Signs
14.
PLoS One ; 16(12): e0261272, 2021.
Article in English | MEDLINE | ID: covidwho-1581756

ABSTRACT

BACKGROUND: First reported case of Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in Kazakhstan was identified in March 2020. Many specialized tertiary hospitals in Kazakhstan including National Research Cardiac Surgery Center (NRCSC) were re-organized to accept coronavirus disease 2019 (COVID-19) infected patients during summer months of 2020. Although many studies from worldwide reported their experience in treating patients with COVID-19, there are limited data available from the Central Asia countries. The aim of this study is to identify predictors of mortality associated with COVID-19 in NRCSC tertiary hospital in Nur-Sultan, Kazakhstan. METHODS: This is a retrospective cohort study of patients admitted to the NRCSC between June 1st-August 31st 2020 with COVID-19. Demographic, clinical and laboratory data were collected from electronic records. In-hospital mortality was assessed as an outcome. Patients were followed-up until in-hospital death or discharge from the hospital. Descriptive statistics and factors associated with mortality were assessed using univariate and multivariate logistic regression models. RESULTS: Two hundred thirty-nine admissions were recorded during the follow-up period. Mean age was 57 years and 61% were males. Median duration of stay at the hospital was 8 days and 34 (14%) patients died during the hospitalization. Non-survivors were more likely to be admitted later from the disease onset, with higher fever, lower oxygen saturation and increased respiratory rate compared to survivors. Leukocytosis, lymphopenia, anemia, elevated liver and kidney function tests, hypoproteinemia, elevated inflammatory markers (C-reactive protein (CRP), ferritin, and lactate dehydrogenase (LDH)) and coagulation tests (fibrinogen, D-dimer, international normalized ratio (INR), and activated partial thromboplastin time (aPTT)) at admission were associated with mortality. Age (OR 1.2, CI:1.01-1.43), respiratory rate (OR 1.38, CI: 1.07-1.77), and CRP (OR 1.39, CI: 1.04-1.87) were determined to be independent predictors of mortality. CONCLUSION: This study describes 14% mortality rate from COVID-19 in the tertiary hospital. Many abnormal clinical and laboratory variables at admission were associated with poor outcome. Age, respiratory rate and CRP were found to be independent predictors of mortality. Our finding would help healthcare providers to predict the risk factors associated with high risk of mortality. Further investigations involving large cohorts should be provided to support our findings.


Subject(s)
COVID-19/mortality , Hospital Mortality/trends , Adult , Age Factors , Aged , Biomarkers , COVID-19/epidemiology , Cohort Studies , Female , Hospitalization/statistics & numerical data , Hospitalization/trends , Humans , Kazakhstan/epidemiology , Male , Middle Aged , Prognosis , Respiratory Rate , Retrospective Studies , Risk Factors , SARS-CoV-2/pathogenicity
15.
Appl Physiol Nutr Metab ; 46(7): 753-762, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1571437

ABSTRACT

We sought to determine the impact of wearing cloth or surgical masks on the cardiopulmonary responses to moderate-intensity exercise. Twelve subjects (n = 5 females) completed three, 8-min cycling trials while breathing through a non-rebreathing valve (laboratory control), cloth, or surgical mask. Heart rate (HR), oxyhemoglobin saturation (SpO2), breathing frequency, mouth pressure, partial pressure of end-tidal carbon dioxide (PetCO2) and oxygen (PetO2), dyspnea were measured throughout exercise. A subset of n = 6 subjects completed an additional exercise bout without a mask (ecological control). There were no differences in breathing frequency, HR or SpO2 across conditions (all p > 0.05). Compared with the laboratory control (4.7 ± 0.9 cmH2O [mean ± SD]), mouth pressure swings were smaller with the surgical mask (0.9 ± 0.7; p < 0.0001), but similar with the cloth mask (3.6 ± 4.8 cmH2O; p = 0.66). Wearing a cloth mask decreased PetO2 (-3.5 ± 3.7 mm Hg) and increased PetCO2 (+2.0 ± 1.3 mm Hg) relative to the ecological control (both p < 0.05). There were no differences in end-tidal gases between mask conditions and laboratory control (both p > 0.05). Dyspnea was similar between the control conditions and the surgical mask (p > 0.05) but was greater with the cloth mask compared with laboratory (+0.9 ± 1.2) and ecological (+1.5 ± 1.3) control conditions (both p < 0.05). Wearing a mask during short-term moderate-intensity exercise may increase dyspnea but has minimal impact on the cardiopulmonary response. Novelty: Wearing surgical or cloth masks during exercise has no impact on breathing frequency, tidal volume, oxygenation, and heart rate However, there are some changes in inspired and expired gas fractions that are physiologically irrelevant. In young healthy individuals, wearing surgical or cloth masks during submaximal exercise has few physiological consequences.


Subject(s)
Exercise/physiology , Heart Rate , Masks , Oxyhemoglobins/metabolism , Respiratory Rate , Adult , COVID-19/prevention & control , Carbon Dioxide/physiology , Dyspnea/physiopathology , Equipment Design , Exercise Test , Face , Female , Humans , Male , Mouth/physiology , Oxygen/physiology , Partial Pressure , Pressure , Skin Temperature , Tidal Volume , Young Adult
16.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 7582-7585, 2021 11.
Article in English | MEDLINE | ID: covidwho-1566204

ABSTRACT

One deadly aspect of COVID-19 is that those infected can often be contagious before exhibiting overt symptoms. While methods such as temperature checks and sinus swabs have aided with early detection, the former does not always provide a reliable indicator of COVID-19, and the latter is invasive and requires significant human and material resources to administer. This paper presents a non-invasive COVID-19 early screening system implementable with commercial off-the-shelf wireless communications devices. The system leverages the Doppler radar principle to monitor respiratory-related chest motion and identifies breathing rates that indicate COVID-19 infection. A prototype was developed from software-defined radios (SDRs) designed for 5G NR wireless communications and system performance was evaluated using a robotic mover simulating human breathing, and using actual breathing, resulting in a consistent respiratory rate accuracy better than one breath per minute, exceeding that used in common medical practice.Clinical Relevance-This establishes the potential efficacy of wireless communications based radar for recognizing respiratory disorders such as COVID-19.


Subject(s)
COVID-19 , Respiratory Rate , Humans , SARS-CoV-2
17.
Sensors (Basel) ; 21(23)2021 Nov 23.
Article in English | MEDLINE | ID: covidwho-1560624

ABSTRACT

Non-contact physiological measurements based on image sensors have developed rapidly in recent years. Among them, thermal cameras have the advantage of measuring temperature in the environment without light and have potential to develop physiological measurement applications. Various studies have used thermal camera to measure the physiological signals such as respiratory rate, heart rate, and body temperature. In this paper, we provided a general overview of the existing studies by examining the physiological signals of measurement, the used platforms, the thermal camera models and specifications, the use of camera fusion, the image and signal processing step (including the algorithms and tools used), and the performance evaluation. The advantages and challenges of thermal camera-based physiological measurement were also discussed. Several suggestions and prospects such as healthcare applications, machine learning, multi-parameter, and image fusion, have been proposed to improve the physiological measurement of thermal camera in the future.


Subject(s)
Respiratory Rate , Signal Processing, Computer-Assisted , Algorithms , Heart Rate , Machine Learning
18.
Eur Rev Med Pharmacol Sci ; 25(22): 7144-7150, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1552081

ABSTRACT

OBJECTIVE: This study aimed to investigate the association between hyperglycemia and body mass index (BMI), along with other associated comorbidities in hospitalized COVID-19 patients among the Indonesian population. PATIENTS AND METHODS: This was a retrospective study conducted at Hasan Sadikin Hospital, Bandung between March 1, 2020, and August 30, 2020. Data were analyzed using the chi-square test for categorical data and unpaired t-test and Mann-Whitney alternative test for numerical data using SPSS version 24.0 (IBM SPSS Statistics for Windows, Version 24.0. IBM, Armonk, NY, USA) and GraphPad Prism version 7.0 for Windows. RESULTS: A total of 142 hospitalized COVID-19 patients were documented between March and August 2020 at the Hasan Sadikin Hospital. Among the 142 patients, 116 (81.7%) survived, while 26 (18.3%) died. Sex, age, BMI, number of comorbidities, heart rate, respiratory rate, peripheral oxygen saturation, platelet count, random blood glucose (RBG), and length of stay (LOS) were significantly associated with mortality. Multivariate analyses demonstrated that admission RBG levels > 140 mg/dl were independently associated with an increased risk of mortality in COVID-19 patients (OR 4.3, 95% CI 1.1-17.5, p = 0.043), while BMI > 25 kg/m2 was significantly associated with reduced mortality (OR, 0.22; 95% CI 0.05-0.88, p = 0.033). CONCLUSIONS: Admission hyperglycemia, indicated by an increase in RBG levels >140 mg/dL, is independently associated with an increased risk of mortality in hospitalized COVID-19 patients, while obesity (BMI >25 kg/m2) might have protective properties against the risk of death.


Subject(s)
Blood Glucose/analysis , COVID-19/mortality , Hospitalization/statistics & numerical data , Hyperglycemia/complications , Obesity/complications , Adult , Aged , Body Mass Index , COVID-19/blood , COVID-19/diagnosis , COVID-19/virology , Comorbidity , Female , Heart Rate/physiology , Hospitalization/trends , Humans , Indonesia/epidemiology , Length of Stay/statistics & numerical data , Male , Middle Aged , Platelet Count , Respiratory Rate/physiology , Retrospective Studies , Risk Factors , SARS-CoV-2/genetics
19.
Eur J Pharmacol ; 914: 174615, 2022 Jan 05.
Article in English | MEDLINE | ID: covidwho-1549762

ABSTRACT

In this study, the therapeutic efficacy of quercetin in combination with remdesivir and favipiravir, were evaluated in severe hospitalized COVID-19 patients. Our main objective was to assess the ability of quercetin for preventing the progression of the disease into critical phase, and reducing the levels of inflammatory markers related to SARS-Cov-2 pathogenesis. Through an open-label clinical trial, 60 severe cases were randomly divided into control and intervention groups. During a 7-day period, patients in the control group received antivirals, i.e., remdesivir or favipiravir, while the intervention group was treated with 1000 mg of quercetin daily in addition to the antiviral drugs. According to the results, taking quercetin was significantly associated with partial earlier discharge and reduced serum levels of ALP, q-CRP, and LDH in the intervention group. Furthermore, although the values were in normal range, the statistical outputs showed significant increase in hemoglobin level and respiratory rate in patients who were taking quercetin. Based on our observations, quercetin is safe and effective in lowering the serum levels of ALP, q-CRP, and LDH as critical markers involved in COVID-19 severity. However, according to the non-significant borderline results in comparing the mortality, the ICU-admission rate, and the duration of ICU-admission, further studies can be helpful to compensate the limitations of our study and clarify the therapeutic potential of quercetin in COVID-19 treatments.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Amides , COVID-19 , Pyrazines , Quercetin , Adenosine Monophosphate/administration & dosage , Adenosine Monophosphate/adverse effects , Alanine/administration & dosage , Alanine/adverse effects , Amides/administration & dosage , Amides/adverse effects , Antioxidants/administration & dosage , Antioxidants/adverse effects , Antiviral Agents/administration & dosage , Antiviral Agents/adverse effects , Biomarkers/blood , COVID-19/diagnosis , COVID-19/drug therapy , COVID-19/immunology , COVID-19/mortality , Drug Monitoring/methods , Drug Monitoring/statistics & numerical data , Female , Hemoglobins/analysis , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Patient Discharge/statistics & numerical data , Pyrazines/administration & dosage , Pyrazines/adverse effects , Quercetin/administration & dosage , Quercetin/adverse effects , Respiratory Rate/drug effects
20.
J Perianesth Nurs ; 37(1): 94-99, 2022 02.
Article in English | MEDLINE | ID: covidwho-1536923

ABSTRACT

PURPOSE: The purpose of this study was to investigate the effect of protective face mask usage during the postoperative period on carbon dioxide retention in children during the COVID-19 pandemic. DESIGN: This study was designed as a prospective, randomized trial including 40 ASA I-II patients aged 3 to 10 years who were scheduled for elective surgery. METHODS: Patients were randomly allocated to two groups. The first group (group 1) received O2 treatment over the protective face mask. In the second group (group 2), the protective face mask was worn over the O2 delivery system. Heart rate, oxygen saturation (SPO2) level, end-tidal carbon dioxide (EtCO2) level, and respiratory rate were measured using a patient monitor at 0, 5, 10, 15, 30, and 45 minutes and recorded. The primary outcome of the study was the determination of the EtCO2 levels, which were used to assess the safety of the mask in terms of potential carbon dioxide retention. FINDINGS: None of the participants' SPO2 levels fell below 92% while wearing masks. There was no statistically significant difference between the groups in terms of EtCO2, heart rate, SPO2, and respiratory rate (P > .05). CONCLUSIONS: During the COVID-19 pandemic, protective surgical face masks can be used safely in the postoperative period for pediatric patients aged 3 to 10 years.


Subject(s)
COVID-19 , Masks , Child , Child, Preschool , Humans , Pandemics , Prospective Studies , Respiratory Rate , SARS-CoV-2
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